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Updated: Jun 21, 2025

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Warfarin Therapy and Percutaneous Left Atrial Appendage Closure for a Patient with Atrial Fibrillation and

Sho Shimohama1, Masahiro Katsumata1, Shumpei Azami1

  • 1Department of Neurology, Keio University School of Medicine, Tokyo, Japan.

The Keio Journal of Medicine
|July 10, 2024
PubMed

Some patients develop ischemic stroke despite taking direct oral anticoagulants because of the presence of other risk factors such as coagulopathies. A 65-year-old male patient with non-valvular atrial fibrillation (NVAF) taking rivaroxaban was diagnosed as having embolic stroke and antithrombin-III (AT-III) deficiency. Echocardiography revealed a thrombus in the left atrial appendage (LAA). He was prescribed warfarin, and after resolution of the thrombus, we successfully performed percutaneous LAA closure (LAAC), with no subsequent recurrence or device-related thrombosis. Warfarin and LAAC may be feasible for NVAF patients with AT-III deficiency.

Keywords:
anticoagulantsantithrombin-III deficiencyatrial fibrillationischemic strokeleft atrial appendage thrombus

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